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Perceived Quality of Life and Preferences for Life-Sustaining Treatment in Older Adults

Author

Uhlmann, Richard F.

Pearlman, Robert A.

Bibliographic Citation

Archives of Internal Medicine. 1991 Mar; 151(3): 495-497.

Abstract

We investigated whether perceived quality of life is associated with
preferences for life-sustaining treatment for older adults. Participants
included chronically ill, elderly outpatients (N=258) and their primary
physicians (N=105). Patients and physicians were independently administered a
questionnaire regarding patient quality of life and preferences for
cardiopulmonary resuscitation and mechanical ventilation for the patient.
Physicians rated patients' global quality of life, physical comfort, mobility,
depression, anxiety, and family relationships significantly worse than did
patients. Nearly all perceptions of patients' quality of life were
significantly associated with physicians' perceptions, but not patients'
treatment preferences. Patient-physician agreement on patient global quality
of life was not significantly associated with agreement regarding treatment
preferences. We conclude that primary physicians generally consider their
older outpatients' quality of life to be worse than do the patients....

BACKGROUND: Treatment preferences established before life-threatening
illness occurs may differ from actual decisions because of changes in
preferences or poor understanding of the link between prospective preferences
and ...